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ALL MEDICAL CODES IN CATEGORY Other Services

2025 HCPCS code M1264

Patient was 75 or older at the start of dialysis.

2025 HCPCS code M1205

Itch severity assessment score is reduced by 3 or more points from the initial (index) assessment score to the follow-up visit score.

2025 HCPCS code G0496

Skilled services of a licensed practical nurse (LPN), in the training and/or education of a patient or family member, in the home health or hospice setting, each 15 minutes.

2025 HCPCS code M1365

Records a patient encounter with a hospice and palliative care provider (specialty code 17) during a performance period.

2025 HCPCS code G0518

Removal and reinsertion of four or more non-biodegradable drug delivery implants.

2025 HCPCS code G0490

Face-to-face home health nursing visit by a rural health clinic (RHC) or federally qualified health center (FQHC) in an area with a shortage of home health agencies (services limited to RN or LPN only)

2025 HCPCS code M1269

Receiving end-stage renal disease (ESRD) monthly capitated payment (MCP) dialysis services by the provider on the last day of the reporting month.

2025 HCPCS code M1355

Assessment of suicide risk based on clinician evaluation or a clinician-rated tool.

2025 HCPCS code M1354

This code tracks the absence of a suicide safety plan initiation, review, or update within specific timeframes of a clinical encounter.

2025 HCPCS code M1347

Patient achieved a net increase of at least 3 points in their Patient Activation Measure (PAM) score within 6-12 months.

2025 HCPCS code T1014

Telehealth transmission, per minute. Professional services billed separately.

2025 HCPCS code M1240

Patient did not respond to the question of whether they felt the provider and team put their best interests first when making recommendations about their care.

2025 HCPCS code M1261

Documents that the patient was on the kidney or kidney-pancreas transplant waitlist before starting dialysis.

2025 HCPCS code M1319

Patients who had documented contact with a community service provider (CSP) for at least one of their screened positive health-related social needs (HRSNs) within 60 days after screening.

2025 HCPCS code M1368

Participation in the Prevention and Treatment of Infectious Disorders Including Hepatitis C and HIV MIPS Value Pathways (MVP) program.

2025 HCPCS code M1170

Patient did not receive an influenza vaccine between July 1st of the prior year and June 30th of the current year.

2025 HCPCS code M1180

Patients receiving immune checkpoint inhibitor therapy.

2025 HCPCS code M1224

Intraocular pressure (IOP) reduced by a value less than 20% from the pre-intervention level.

2025 HCPCS code M1248

Patient responded "completely true" to the question of whether they felt the provider and team saw them as a person, not just someone with a medical problem.

2025 HCPCS code M1164

Patients with dementia any time during the patient's history through the end of the measurement period.

2025 HCPCS code M1335

Documentation of patient reason(s) for not having a follow-up exam (e.g., inadequate time for follow up).

2025 HCPCS code M1327

This code is used for patients who did not receive an appropriate initial evaluation or a re-evaluation within 8 weeks, as required.

2025 HCPCS code M1176

Patient did not receive two doses of the herpes zoster recombinant vaccine (at least 28 days apart) on or after their 50th birthday.

2025 HCPCS code G0514

Prolonged preventive service, requiring direct patient contact beyond the usual service time, for each additional 30 minutes beyond the first 30 minutes (reported with G0513).

2025 HCPCS code M1225

Intraocular pressure (IOP) reduced by at least 20% from pre-intervention level.

2025 HCPCS code M1226

IOP measurement not documented, reason not otherwise specified.

2025 HCPCS code G0494

Skilled services provided by a Licensed Practical Nurse (LPN) for observation and assessment of a patient's condition, specifically when a change in the patient's condition requires skilled nursing evaluation, billed in 15-minute increments.

2025 HCPCS code G0472

Hepatitis C antibody screening for individuals at high risk and other covered indications.

2025 HCPCS code G0493

Skilled services of a registered nurse (RN) for the observation and assessment of the patient's condition, each 15 minutes.

2025 HCPCS code G0471

Collection of venous blood by venipuncture or urine sample by catheterization from a patient in a skilled nursing facility (SNF) or for a home health agency (HHA).

2025 HCPCS code G0500

Moderate sedation services provided by the same physician performing a gastrointestinal endoscopic procedure, requiring an independent observer; initial 15 minutes, patient 5+ years old.

2025 HCPCS code T1H

Lab tests - other (non-medicare fee schedule).

2025 HCPCS code M1298

Documentation of patient pregnancy anytime during the measurement period prior to and including the current encounter.

2025 HCPCS code M1246

Patient did not report "completely true" to the question, "Patient felt this provider and team understood what is important to me in my life."

2025 HCPCS code G9940

Documentation of medical reason(s) for a patient not being on statin therapy.

2025 HCPCS code M1307

Documentation stating the patient has received or is currently receiving palliative or hospice care.

2025 HCPCS code M1322

Screening for elevated intraocular pressure (IOP) with tonometry, IOP ≤25 mm Hg, within 7 weeks of injection.

2025 HCPCS code M1333

Acute vitreous hemorrhage.

2025 HCPCS code M1211

Most recent hemoglobin A1c level > 9.0%

2025 HCPCS code M1150

Left ventricular ejection fraction (LVEF) less than or equal to 40% or moderately/severely depressed left ventricular systolic function.

2025 HCPCS code M1208

This code represents a patient not screened for food insecurity, housing instability, transportation needs, utility difficulties, and interpersonal safety.

2025 HCPCS code M1151

This code identifies patients with a history of heart transplant or with a left ventricular assist device (LVAD).

2025 HCPCS code M1260

Patient not listed on kidney-pancreas transplant waitlist and did not receive a living donor transplant within one year of starting dialysis.

2025 HCPCS code M1163

Patient had anaphylaxis due to the HPV vaccine on or before the patient's 13th birthday. This is a tracking code for performance measurement.

2025 HCPCS code M1203

This code is used for patients with chronic kidney disease and proteinuriawho were not prescribed ACE inhibitor or ARB therapy during the measurement period, and no reason was given for not prescribing.

2025 HCPCS code M1204

Initial itch severity assessment score of 4 or greater using NRS, VRS, or ItchyQuant.

2025 HCPCS code M1250

Patient responded "completely true" to the question of feeling heard and understood by the provider and team.

2025 HCPCS code M1147

Ongoing care not medically possible due to early discharge for medical reasons.

2025 HCPCS code M1222

Glaucoma plan of care not documented, reason not otherwise specified.

2025 HCPCS code M1165

Patient received hospice care during the measurement period.